63688 prior authorization | Anthem Blue Cross Blue Shield of Georgia

63688, Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array, is on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage or referral decision.

Code: 63688
Description: Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array
Source: Standard Local Prior Authorization Code List, Pg 28 Original policy

Anthem Blue Cross Blue Shield of Georgia prior authorization

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